Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | K5246 | TX |
NPI | 1033162672 |
---|---|
Provider Name | Christopher Ziebell |
First Address | Austin, TX 78731-2154 |
Second Address | Austin, TX 78701-1930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
129211202 | (05) | TX |
F57787 | (02) | TX |